Gender dysphoria diagnoses in the United States increased in all but one state in recent years, suggesting that a growing number of transgender people are seeking health care.

Gender dysphoria “refers to psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity,” according to the American Psychiatric Association. 

Not all transgender people experience dysphoria. Treatment can include social shifts, such as wearing different clothing or going by a different name, or medical affirmation, which can involve puberty blockers, hormone treatment, and surgery. Medical treatment — gender-affirming care — typically requires a diagnosis from a health care professional before patients can receive it.

Despite a growing number of states seeking to ban gender-affirming care for minors and restrict the care for adults, more people are beginning to seek it by receiving a diagnosis, a recent report from Definitive Healthcare found. 

Virginia, Indiana, and Utah were the states with the greatest increase in diagnoses between 2018 and 2022 The only state to see a decrease was South Dakota, which banned gender-affirming care for minors in 2023. 

South Dakota lawmakers had attempted to pass legislation banning care in 2020, which the report stated likely had “the dual chilling effects of reduced access to sympathetic providers and the self-directed seeking of care in states where long-term access was protected.”

The report also noted that “other states with bans on gender-affirming care for youth have seen year-to-year dips in gender dysphoria diagnoses, too,” though this does not necessarily indicate that less transgender residents are seeking care, but rather “possibly indicating that shifting social and political climates have pushed young patients and their parents to seek diagnoses in states that are friendlier to trans people.”

For patients under the age of 18, gender dysphoria diagnoses increased from 17.5 percent to 20.4 percent during the four-year period. The report notes this could be reflective of transgender identities becoming “more accepted by society,” in spite of the legislators pushing health care bans. 

The Williams Institute estimates that 1.6 million people in the U.S. are transgender, nearly 20 percent of them being between the ages of 13 and 17. Among transgender youth, 35.1 percent (105,200 total) live in states that have restricted access to gender-affirming care, according to the Human Rights Campaign.